Healthcare Provider Details

I. General information

NPI: 1881569879
Provider Name (Legal Business Name): OLIVIA CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVE
HACKENSACK NJ
07601-1915
US

IV. Provider business mailing address

90 GORDONHURST AVE
MONTCLAIR NJ
07043-1716
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-2000
  • Fax: 551-996-1838
Mailing address:
  • Phone: 801-867-9796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ14999200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ14999200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: